Study the Relationship Between Cognitive Impairment and Sub-clinical Hypothyroidism in a Sample of Egyptian Population

Abstract

Subclinical hypothyroidism (SCH) is characterized by a normal range of free thyroxin concentrations together with increased serum thyroxin (thyroid stimulating hormone, TSH) levels. Recently, SCH was found in 5–10% of the general population and 6–10% of women (approximately 15% was found in women >60 years old), while the incidence in males was 2.4–3%. Although SCH is frequently asymptomatic, approximately 30% of patients have symptoms indicative of thyroid hormone deficiency. However, the clinical significance and therapeutic strategies of SCH are controversial. Over the past 20 years, there have been major advances in understanding the neural basis for cognitive processes. Cognitive domains include attention and concentration, language, memory, psychomotor function, and executive function. These domains map to neural systems that involve multiple, often overlapping brain regions. Because thyroid hormone has profound effects on the central nervous system, it is logical to ask how thyroid dysfunction affects cognition. The aim of our study is to detect the effect of levothyroxine therapy on cognitive impairment in patients with sub-clinical hypothyroidism . This was Prospective cohort study conducted on 30 patients with cognitive impairment and subclinical hypothyroidism attending Endocrine outpatient clinic at Ain Shams University Hospital to study the effect of levothyroxine therapy on Cognitive Impairment in patients with Sub-clinical Hypothyroidism. The sudy conducted on 30 patients with cognitive impairment and subclinical hypothyroidism, 23 patient of them were female (76.67%) and 7 male patients (23.33). Our study shows that only 11 patient (36.67%) had goiter, with 19 patient (63.33%) had normal neck US. Our study shows that there is highly statistically significance regarding all clinical data in both 3 months and 6 months after treatment with levothyroxine therapy with p value <0.001 . Also shows that there is high statistically significant difference before treatment and after 3 months and 6 months of treatment with levothyroxine therapy regarding TSH , LDL , T. cholesterol , carotid intima media thickness and Addenbrooke's questionnaire results with p value <0.001 . Also shows that there is statistically significant difference before treatment and after 3 months and 6 months of treatment with levothyroxine therapy regarding FT3, FT4 and HDL .